Prescription Digital Therapeutics and the Need to Expand Knowledge Among Pharmacists

While the number of prescription digital therapeutics (PDTs) continues to expand as possible treatments or adjunctive treatments for the management and prevention of various medical conditions, the degree of knowledge about the availability of PDTs appears to be still limited among both health care providers and patients who may benefit from them.

Various health care providers were asked about their knowledge and use of PDTs, and the following responses were obtained:

A pharmacist practicing in a community setting stated, “I have read about prescription digital therapeutics, especially one recently approved in July for patients with type 2 diabetes, but have not encountered a patient inquiring about them. From what I have read, they may offer several advantages for patients, especially those who want to take an active role in their health or a proactive role in preventive care. They also appear to offer more personalized care, which may improve adherence and clinical outcomes. ”

A pharmacist practicing in a hospital setting stated, “I have not heard about prescription digital therapeutics, but it sounds promising since technology is becoming a vital component of health care, and patients may like the idea of using technology for treatments. I would definitely like to learn more about them so that I can be prepared if a prescriber or patient asks me about them.”

Recent Literature and Data on PDTs

In a recent publication in the journal Pharmacy Today,¹ the author discussed the issue of expanding the use of PDTs and also included information from a recent commentary in the Journal of the American Pharmacists Association², which explored the use of both digital therapeutics and the role of pharmacists. In the article, authors Timothy Aungst, PharmD, associate professor of pharmacy practice at the Massachusetts College of Pharmacy and Health Sciences, and Gigi Shafai, PharmD, stated, “There isn’t much information in the published literature about DTx and PDTs for pharmacists to read about at this time. Most published literature is targeted toward payers and health care decision-makers, and yet very little toward helping the majority of pharmacists understand what new technological developments are going on in health care.”^1,2 The health experts also indicated that there will be continuing changes and updates to the role of digital health data in helping clinicians make essential modifications to therapies per patient need, and pharmacists will need to be equipped to comprehend how novel technologies will affect a patient’s medication regimen.^1,2 Additionally, Dr. Shafai stated, “Pharmacists will need further education and training on digital health tools such as PDTs since they may be involved in direct dispensing or support.” 1,2

In a recent publication in Advances in Therapy,₃ authors indicated that the slow acceptance and integration of PDTs into clinical practice may be due to many clinicians not being familiar with PDTs.3. The authors recommended that information about PDTs and other digital technologies be integrated into curriculums for these health care providers to expand knowledge of PDTs.³ The authors wrote, “Much work remains to facilitate full integration of PDTs into clinician and organizational workflows, to ensure coverage of these treatments for patients, and to streamline all of the steps required to prescribe and implement PDTs for the patients who need them."3

In a press release, the manufacturer Akilli announced its strategic plan to shift from a prescription to a non-prescription business model to pursue regulatory approval for over-the-counter labeling of its products.^4,5 In June 2023, the company released EndeavorOTC, created on the same technology as Akili’s EndeavorRx, the world’s first and only FDA-authorized video game treatment prescribed for children 8-12 years old with ADHD. EndeavorOTC is now available without a prescription for adults 18 years and older nationwide.^4,5 For more information, click here.

Conclusion

Health experts indicate that the number of digital therapeutics and PDTs is increasing, and the role of technology in treatments continues to evolve. Due to their unique mechanism of action, PDTs provide prescribers and patients with additional treatment options for certain conditions beyond the scope of conventional therapies, which can be used as stand-alone therapies or in conjunction with traditional therapies.² The latest PDT was approved in July 2023 as a behavioral therapeutic device for adults with T2DM, and the indications for PDTs continue to grow. There is clearly a need to expand awareness about these therapies and their roles in the treatment paradigm. In order to counsel patients about PDTs and identify ideal candidates who may benefit from the innovative treatments, pharmacists should explore the available information about PDTs.

Valuable Resources

Valuable resources include:

• Digital Therapeutics Alliance website
• FDA Digital Health Center of Excellence 
• AMCP Prescription Digital Therapeutics 

References

1. Increasing use of prescription digital therapeutics. American Pharmacists Association. https://pharmacist.com/Publications/Pharmacy-Today/Article/increasing-use-of-prescription-digital-therapeutics. Accessed September 22, 2023.
2. Shafai G, Aungst TD. Prescription digital therapeutics: A new frontier for pharmacists and the future of treatment. J Am Pharm Assoc (2003). 2023;63(4):1030-1034. doi:10.1016/j.japh.2023.03.012. 
3. Brezing CA, Brixner DI. The rise of prescription digital therapeutics in behavioral health. Adv Ther. 2022;39(12):5301-5306. doi:10.1007/s12325-022-02320-0. 
4. Akili Announces Business Transformation, Focusing on Non-prescription Model - Akili. investors.akiliinteractive.com. https://investors.akiliinteractive.com/news/news-details/2023/Akili-Announces-Business-Transformation-Focusing-on-Non-prescription-Model/default.aspx. Accessed September 22, 2023.
5. Akili Releases EndeavorOTCTM Video Game Treatment to Improve Attention in Adults with ADHD - Akili. investors.akiliinteractive.com.  https://investors.akiliinteractive.com/news/news-details/2023/Akili-Releases-EndeavorOTCTM-Video-Game-Treatment-to-Improve-Attention-in-Adults-with-ADHD/default.aspx. Accessed September 22, 2023.